Prognostic Biomarkers at Discontinuation of Renal Replacement Therapy in Acute Kidney Injury Patients in the Intensive Care Unit

obtained 16–48 h after the discontinuation of RRT. The levels of serum osteopontin (sOPN), interleukin-6 (IL-6), IL-18, neutrophil gelatinase-associated lipocalin and cystatin C were measured by sandwich enzyme-linked immunosorbent assay or immunoturbidimetric assay. Patients were followed up for 90-day survival. Eleven (26.2%) patients died during follow-up. The mean levels of all biomarkers were higher in death group. Diabetes, Charlson comorbidity index, sepsis, APACHE II score, all biomarkers, sCr and UO were included in the primary logistic regression analysis. By the enter method, the final model identified no sepsis (OR Dear Editor, There remains uncertainty about the optimal timing of discontinuing renal replacement therapy (RRT) in acute kidney injury (AKI) patients in the intensive care unit (ICU) [1] . Conventional indicators such as serum creatinine (sCr) and urine output (UO) may be susceptible and not accurate enough to reflect the progress or repair. Biomarkers are involved in the pathogenesis of AKI [2] . Sensitive and specific novel biomarkers at an early stage of AKI have been reported to be early predictors of the need for RRT [3] . Nevertheless, the predictive values of biomarkers at the time of discontinuing RRT for mid-term survival-related successful weaning of RRT are unknown. To seek biomarker reference indicators for the discontinuation of RRT, we performed a preliminary prospective observational study in the ICUs of West China Hospital of Sichuan University, China. The study was approved by the local ethics Committee and written informed consent was obtained from participants. The study enrolled 42 RRT-requiring AKI patients who weaned and remained independent from RRT or died without requirement of acute re-initiation. RRT was stopped when azotemia, oliguria, acidosis and hyperkalemia were significantly improved. In order to reduce the possible influence of clearance effect of RRT, blood samples were Received: April 28, 2016 Accepted: October 3, 2016 Published online: November 11, 2016